A house rat feeling cornered in a mousetrap.

AAO Day One: Don’t You Know I’m Caught in a Trap?

We’re caught in a trap… can’t walk out… 

Elvis Presley’s song does seem to ring a little true of 2020 does it not?

Most of us have been caught in the trap of lockdowns, some of us several times, so I think I can speak for all of us when I say, thank the big man upstairs that 2020 is coming to a close. Good news does appear to be on the horizon with a potential vaccine on the way thanks to Pfizer, but there are more glad tidings too.

The annual meeting of the American Academy of Ophthalmology (AAO 2020 Virtual) is here, and while it may be bittersweet that this is the final big conference of the year, the CAKE & PIE teams are so excited to participate. Originally scheduled to be held in Las Vegas, Nevada, the AAO 2020 Virtual is jam packed with 100 hours of live sessions and 700 plus hours of recorded content you can watch at your leisure. Not only that, but all the posters, presentations, videos and content you would usually expect to consume at a top level ophthalmology conference make an appearance too.

My love (for ophthalmology) is like a red, red rose

AAO Day One: Don’t You Know I’m Caught in a Trap?
For auld lang syne, my jo, for auld lang syne!

Once again, the organization and production values of a major ophthalmological conference did not fail to impress us. Based around the online stage format, with a theatre hall, lobby, on demand section etc, the live sessions were easy to be immediately played back by the viewer. This is likely to prove as beneficial to opthamologists wanting to catch up on any missed information as much as it would a writer…

President of the AAO Dr. Anne L Coleman began the day by welcoming the attendees, while noting that for many of us, 2020 did not go according to plan. The year was earmarked to be the ‘year of the eye’ according to Dr. Coleman, but of course the focus of the medical community was drawn elsewhere.

“As Robert Burns wrote ‘the best laid plans of mice and men often go awry,’ and I am very proud of how quickly our leadership, staff and volunteers helped us pivot to address the COVID-19 pandemic,” Dr. Coleman said.

“Our focus remains on the eye and vision health, but we do not take care of patients in a vacuum. We are part of a broader medical community and society. We have worked hard to protect sight and empower lives. Life is either an adventure or nothing at all, and we are having an adventure,” Dr. Coleman added.

Oopsie daisies… sorry kid!

AAO Day One: Don’t You Know I’m Caught in a Trap?
Even the best of make mistakes…

Following on from the president’s remarks, a number of sessions began, covering a wide array of subjects. Day one was the day of subspecialties, and the morning sessions investigated strategies in glaucoma care, pediatric ophthalmology, refractive surgery, retina as a subspeciality and how to deal with uveitis. With so many exciting sessions to choose from it’s hard to single out a specific subject, but the section on pediatric care was particularly engaging.

The afternoon (that’s Pacific standard time mind you, as some of us were writing this in the middle of the night…) continued the subspecialty theme. Corneal issues, ocular oncology and pathology were examined, as was oculofacial plastic surgery, which proved to be an absolutely fascinating deep dive into the business of tips, tucks and tricks. Retina was also discussed again, focusing on how the subspeciality will continue to develop in the coming years.

PED11V: I Wish I Hadn’t Done That! was a particular interesting examination of when things go wrong in pediatric ophthalmology. Ophthalmology is a practice of medicine not perfection after all, as moderator Dr. Jeffrey Hunter said, and mistakes can happen. A number of case studies were presented covering a wide array of conditions.

Dr. Jane Edmond from Austin, Texas, presented her own case study, a 15-year-old boy with 20/20 visual acuity and a newly found blind spot in the eye. He also had a unilateral altitudinal defect. Dr. Edmond admits she was thrown off by the placement of the true optic nerve, however, she eventually diagnosed superior segmental optic hypoplasia.

Papers and posters, lenses and tumors

Of course it would not be a top notch Vegas sized ophthalmological conference without some top quality poster presentations. There were hundreds to choose from this year, and kudos to all the researchers and presenters for their time. One of the particular standouts for the CAKE & PIE team was FNAB of Posterior Segment Tumors in 500 Consecutive Cases.

Led by Dr. Chloe Kwoo at Wills Eye Hospital, the groups of researchers behind the paper examined complications of fine-needle aspiration biopsy. More specifically, they examined 500 patients who underwent FNAB for cytopathology of posterior segment tumors. They subsequently concluded that FNAB is a reliable technique for cytopathologic identification of posterior segment tumors, providing adequate samples in 86% of cases.

Now something that the CAKE & PIE team cares about is safety, whether that be maintaining social distancing, working through typhoons (yes, that’s happened before — and also right now actually in our satellite Danang, Vietnam office), or proper contact lens wear.

Media MICE Weatherman and CEO Matt Young reports on Typhoon Vamco during the AAO Virtual meeting, covered live by Media MICE for the globe from Da Nang, Vietnam. Media MICE staff covered AAO Virtual during the storm, from across the globe, in an interesting set of circumstances. COVID-19 forced AAO to go virtual to allow attendance in 2020, and yet some attendees including Media MICE nonetheless barely made it virtually due to other forces of Mother Nature.

The poster Cornea, External Disease, was created to describe differences in outcomes in Pseudomonas aeruginosa keratitis between contact lens wearers (CLW) and non-CLW persons.

The researchers, led by Dr. Rikki Enzor, concluded that non-CLW persons have worse visual acuity outcomes and a much higher rate of clinically significant stromal melting, compared with CLW. Keratitis is a disease that can therefore strike non-CLW persons, but for those that do, we remind you to remove them before you sleep!

And that was day one of the AAO 2020 Virtual, packed full of interesting ophthalmology and excitement. So don’t be cruel or all shook up, make sure you drop by tomorrow, and in the meantime, make sure you check out the CAKE & PIE team’s other reporting from today. It’s Vegas baby!

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